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MAHARASHTRA UNIVERSITY OF HEALTH SCIENCES,

NASHIK

SYLLABUS

Fellowship Course in Body Imaging (CT &


MRI of Chest & abdomen)

1.

Proper name of the course :

Fellowship Course in Body Imaging (CT & MRI


of chest & abdomen)

2.

Duration of the course :

12 Months

3.

Eligibility criteria for admission and intake

MD (Radio-diagnosis) or DNB (Radio-

capacity :

diagnosis) or DMRD (Radio-diagnosis) + 5


years experience
2

4.

Complete curriculum of the course :

Attached

5.

Teaching Scheme : Total periods and

1-2 period per day each period 45 minutes

Periods allotted to each topic :


6

Text books and reference books

Attached

7.

Scheme of examination in details :

Attached

8.

Infrastructure required for conducting the

1 MRI, 1 CT scanners

Course and its availability in your college :


9.

Faculty required with their qualifications & 2 Associate Professo


experience :

Selection Criteria for candidates:


Fellows should be selected in a fair and non-discriminatory manner in accordance with
the Equal Opportunities. The selection process will be according to MUHS guidelines.
The candidate is expected to appear for the multichoice (MCQ) written examination of
100 marks. Selected candidates will be called for the interview. Ultimately, selection
of a candidate for a fellowship will be done by an interview with panel of faculties
constituted by the MUHS.
Examination paper for selection of candidates for Fellowship:
Three sets of MCQ paper will be set by the committee of the faculties approved by
MUHS & only one paper will be selected by random process on the day of
examination.
Evaluation of the examination conducted will be done by a committee of faculties
Merit list & Successful candidates name will appear on the WEB site of MUHS

Syllabus for Fellowship Course in Body Imaging


Diagnostic Cross Sectional Imaging
Normal Chest
Normal anatomy :
Trachea
Main bronchi
Carina
Major and Minor fissure
Bronchopulmonary segments
Pulmonary blood vessels
Segmental bronchi and ascinus
Lung hila
The mediastinum
Diaphragm
Chest wall and pleura
Examination :
Plain radiograph
CT scan and HRCT
MRI Chest

Pleura and Pathologies :


Normal plura
Pleural effusion
Empyema
Bronchopleural fistula
Chylothorax, haemothorax
Pneumothorax
Hydropneumothorax
Complications of pleural effusion
Pleural thickening and fibrohorax
Pleural calcification
Localised pleural tumours : fibromas, lipomas,
Diffuse pleural tumors : mesotheliomas and metastasis
The Diaphragm :
Eventration of diaphragm
Diaphragmatic paralysis
Diaphragmatic hernia : Congenital diaphragmatic hernia, Bockdalek hernia,
Morgagni Hernia
Diaphragmatic trauma
The Mediastinum :
Anterior Mediastinum :
Thyroid and parathyroid masses, thymic masses.
Teratoma and germ cell tumours
Mediastinal Adenopathy :
Forgut Cysts :Bronchogenic cyst
Esophageal duplication cyst
Neuroentric cyst
Pericardial cyst
Pancreatic pseudocyst
Neurogenic Tumors
Neurofibromas
Neurilemmoma (Schwannoma)
Malignant necrogenic tumors

Mediastinal paragangliomas
Lateral thoracic meningocele
Extramedullary haemopoiesis
Lymphangiomas
Lipoma, lipoblastoma, angiolipoma, myelolipoma
Fibrous tumours
Liposarcoma
Aneurysms of aorta
Aortic dissection
Acute mediastinitis
Fibrosing mediastinitis
Mediastinal haemorrhage
Mediastinal emphysema
Pulmonary Infections
Pneumonias :
Gram positive :

Streptococcal
Staphylococcal

Gram negative :

Klebsiella
Legionella
Meliodosis
Mycoplasma pneumonia
Viral pneumonia

Pulmonary Tuberculosis
Primary pulmonary Tuberculosis
Consolidation
Lymphadenopathy
Pleural effusion
Miliary Tuberculosis
Post primary Tuberculosis
Infections :
Aspergillus infection Myectoma
Allergic bronchopulmonary aspergillosis (ABPA)
Chronic necrotizing aspergi
Invasive aspergillosis llosis

Hydatid disease
HIV infection and AIDS
PCP pneumonia
Toxoplasma gondii
Aspergillosis mycobacterium Tuberculosis
Cytomegalovirus
Malignancies
Bronchogenic carcinoma (Adenocarcinoma & squamus cell carcinorma)
Kaposis sarcoma
Nonhodgkins lymphoma
Intestinal Pneumonias
Usual interstitial pneumonias (UIP)
Nonspecific interstitial pneumonias (NSIP)
Lymphocytic interstitial pneumonias (LIP)
Acute interstitial Pneumonias
Bronchogenic organizing pneumonia (BOOP)
Respitatory bronchiolitis
Hypersensitivity pneumonitis acute subacute chronic
Cardiovascular system
Anatomy
Examination
Plain radiograph
CT Scan
MRI
Pathology
Congenital anomlies; ASD, VSD, PDA, TOF, Pulmonary valve stenosis, aortic
stenosis etc.
Acquired anomalies
Ischemic heat disease and cardiac viability
Pulmonary circulation
Pulmonary venous hypertension
Pulmonary artery hypertension
Pulmonary thromboembolism
Cardiomyopathy ; dilated cardiomyopathy, hypertrophic cardiomyopathy, restrictive

cardiomyopathy
Cardiac tumors (Benign and malignant)
The pericardium
Anatomy
Examination
Plain radiograph
CT Scan
MRI
Pathology
Pericarditis
Cardiac tamponade
Constrictive pericarditis
Pericardial neoplasm
The aorta
Anatomy
Examinations
Congential anomalies
Coarctation
Aneursyms
Dissection
Aortitis
The abdomen
Anatomy
Examinations
Plain radiography
Normal appearance & radiographic technique
Abdominal calcification
Dilatation of bowel
Gastric dilatation
Distinction between small and large bowel dilatation
Small bowel obstruction
Small intestinal infarction
Mechanical large bowel obstruction
Acute colitis

Paralytic ileus
Pseudo obstruction
Pst operativ abdomen
The oesophagus
Anatomy and function
Examination
Plain radiograph
Barium
CT Scan
Pathology
Hiatus hernia
Gastro oesophagus reflux
Peptic ulcer stricture
Barretts oesophagus
Tumors (benign and malignant)
Motivative disorders (achalasia, presbyooesophagus)
Extrinsic lesions affecting the oesophagus
The Stomach
Anatomy
Examination
Single caontrast examination
Double contrast examination
Examinaion with water soluble contrast
Computed Tomography
Pathology
Gastric ulcer
Gastric erosions
Gastritis
Atrophic gastritis
Infectious gastritis
Hypotrophic gastritis
ZE Syndrome
Corrosive gastritis
Hiatus hernia

Gastric volvulus
Neoplasms (benign & malignant)
Miscellaneous conditions (diverticula, hypertrophic pyloric stenosis, post
operative stomach)
The Deodenum
Anatomy
Examination
Barium studies
Water soluble contrast
Pathology
Giant duodenal ulcer
Post bulbar ulcer
Peptic ulcer disease and its complications
Diverticuli
Inflammatory conditions (tuberculosis, pancreatitis)
Neoplasms (benign and malignant)
Trauma
The small intestine
Anatomy
Examination
Plain radiograph
Barium FT
Small bowel meal
Enteroclyusis
CT Scan
MRI
Pathology
Celiac disease
Neoplasms (Benign and malignant)
Infections and infestations (tuberculosis)
Chronic radiation enteritis
Small bowel ischemia and infarction
Diverticuli and blind look
Eosinophyllic

AIDS
The large intestine
Anatomy
Examination
Barium enema
CT Scan (virtual colonoscopy)
MRI
Pathology
Megacolon and Hirshsprungs disease
Volvulus
Polyps and syndromes
Neoplasms (Benign and malignant)
Colitis (ulcerative colitis, ischemic, radiation, infectious, TB)
AIDS
Diverticular disease
Solitary rectal ulcer syndrome
Rectum and anal canal
Anatomy
Examinations
Barium enema
Fistulogram
CT Scan
MRI
Pathology
Fistula & fissures in ano
Neoplasms (benign and malignant)
Peritoneum and Mesentery
Anatomy of peritoneal spaces
Pathology
Development and congenital anomalies
Ascities
Infective/inflammatory
Vascular
Traumatic and torsion

Neoplasms (benign and malignant)


The Liver
Normal anatomy
Examination
Plain rariograph
CT Scan
MRI
Pathology
Diffuse liver diseases
Benign diffuse diseases
Fat infiltration
Cirrhosis
Viral hepatitis
Hemochromatosis and iron overload
Malignant diffuse disease
HCC
Lymphoma
Focal disease
Calcification, aerobillia, portal vein gas
Benign cystic lesions
Cysts
Hydatid cysts
Hydatid cysts
Abscess (Cholengitis, pyogenic, amoiebic)
Benign tumors
Hemangioma
FNH
Adenoma
Regenerative nodules
Malignant tumors
HCC
Fibrolamelar carcinoma
Hepatoblastoma
Epitheloid Hemangioendothelioma

Lymphoma
Angiosarcoma
Metastasis
Vascular lesions
Budd chiari-syndrome
Veno occlusive disease
Portal venous hypertension
Portal vein thrombosis
Arterio portal shunts
Hepatic trauma
The Biliary tract
Anatomy (gall bladder, cystic duct, bile duct)
Examination
Plain radiograph
CT Scan
MRI & MRCP
Pathology
Congenital anomlies
Cholelethiasis and its complications
Cholecystitis (acute and chronic)
Cholesterosis
Neoplasms (benign and malignant)
CBD strictures (benign and malignant)
Primary and sclerosing cholangitis
AIDS
Choleodocal cyst
Pancrease
Anatomy
Examination
Plain radiograph
CT Scan
MRI & MRCP
Pathology
Congenital anomalies; pancreatic divism, annular pancreas, ectopic pancrease

Inflammation and infections : Acute pancreatitis, chronic pancreatitis and Complications


Neoplasms (benign and malignant, endocrine and non endocrine, functional and
non functional)
Trauma
Spleen
Anatomy
Examination
Plain radiograph
CT Scan
MRI
Pathology
Spleenomegaly
Inflammation and infection
Benign lesions, splenic cyst, hemangioma, lymphangioma, malignant lesions,
lymphoma, primary tumors, metastasis
Splenic infarct
Trauma
Kidney
Anatomy
Examination
Plain radiograph
IVP
CT Scan
MRI
Pathology
Infection and inflammation
Papillary necrosis
Renal tuberculosis
Xanthoranulomatous pyelonephritis
Emphysematous pyelonephritis
Glomerulonephritis
Renal calculus disease and its complications
Renal cysts and its classification
Benign neoplasms; adenoma, angiomyolypoma, oncocytoma

Malignant neoplasms; RCC, TCC


Urinary Bladder and Prostate
Normal anatomy
Examination
Plain rediograph
IVP
MCU/DRU
CT Scan
MRI
Pathology
Infection and inflammation
Benign neoplasm; adenoma, hemangioma
Malignant neoplasm
Trauma
Uterus and adenexa
Normal anatomy
Examination
Plain radiograph
CT Scan
MRI
Pathology
Obstetric
Fetal anomalies
Placental disorders
Medical conditions associated with pregnancy
Gynecology
Congenital anomalies of uterus
Fibroids
Adenomyomatosis
Malignant tumors
Ovary & adenexa
TO masses (benign and malignant and infections)
Ovarian malignancies
Ovarian torsion

Ectopic pregnancy
Physics
Computed Tomography
Basic principles and components of the system, and detector types
Helical scanning and multi-slice scanners
Operator- controlled variables and their effects on image quality and patient dose
Recognition and explanation of common artefacts
Magnetic Resonance Imaging
Basic principles and components of an MR system
Origin of the MR Signal
Concept of T1, T2 relaxation times and proton density
Basic principles of common sequences in clinical use (spin echo and generic
gradient echo), including MR angiography techniques
Principles of contrast agents
Recognition and understanding of common artfacts
Knowledge of guidance on a safety framework for MR
Knowledge of magnetic field and radiofrequency hazards to patients and staff
Responsibilities: Conducting and interpreting CT and MR examinations in the chest,
abdomen and pelvis. This would include speciality areas likei.

High resolution CT of the chest for interstitial lung disease

ii.

CT angiography of the thoracic aorta and pulmonary vasculature.

iii.

Image guided biopsies and drainages of lung nodules, masses and

abscesses.
iv.

MR angiography of mediastinal vessels.

v.

Hepatobiliary imaging with special emphasis on MR imaging of liver, MR

specific liver contrast media, MRCP and liver tumour imagin


vi. Pancreatic imaging with CT and MRI with emphasis on structure reporting of
pancreatic pathologies like acute and chronic pancreatitis and pancreatic cancer
vii. Multislice CT angiography of abdominal vasculature.
viii. Imaging of acute abdomen.
ix. Nonvascular interventionsa. Image guided biopsies of abdominal masses and lymph nodes.
b. Percutaneous liver biopsies.
c. Image guided drainage of abdominal abscesses.

d. Radiofrequency ablation of liver and lung lesions.


Research: There should be a mandate to make at least one presentation at state level and
national level conferences each. Ideally the fellow should have at least one index
publication during the fellowship period.
List of Books for Fellowship Course in Body Imaging
1.

Gastrointestinal radiology by Levine & Gore

2.

Computed Body Tomography with MRI Correlation by Lee & Segal

3.

High resolution CT of the Lung by Webb

4.

Spiral and multislice computed Tomography of the Body

5.

Diagnostic Radiology by Grainger & Allisans

6.

Lee and Sagel's textbook of CT and MR imaging

7.

Webb, Muller and Naidich HRCT of the chest

8.

Diagnostic imaging series

9.

MR imaging Bradley

Journals: Radiology
American Journal of Radiology
Radiographics
British Journal of Radiology
Abdominal Imaging
Radiologic Clinics of North America
Seminars in Ultrasound CT and MRI
MRI clinics of North America
Maintenance of a log book should be made compulsory.
Attending interdisciplinary meetings especially tumour boards, chest meetings and
GI meetings should be mandatory.
Journal clubs
Didactic teaching: Once a week didactic teaching sessions by experts should be
organized. This should be basically targeted to cover high yield areas from clinical
practice point of view and recent advances.
Film reading sessions: Once a week
Radiology -pathology meetings: should be held once a month or even more frequently
to discuss interesting cases.
Periodic evaluation: 3 monthly viva voce

Final evaluation: Theory and practical including viva voce at the end of the fellowship.
Electives: Nuclear medicine and PET-CT 2 weeks
Anatomy 1 week
Interventional radiology 2 weeks.
SCHEME OF EVALUATION
Evaluation will be done by Credit Based System
Allotment of Credits
Total Credits: 300
Minimum Number of Credits for successful completion of programme:-240 credits
(80%)
Transfer of Credit to and from other Universities: Not at present but will be
informed once broad consensus among other universities is established.
Breakup of credits
It should be based on following Modules
Didactic Credits : ( 25 credit points)
Didactic on various topics as per syllabus spread over One Hour lecture. Total 10-20
Lectures depending upon specified course material and depth of theory.
1.
Presentation, Publications & Project Work ( 25 credit point)
Under faculty guidance, presentations for Local , Regional & national
conferences.
2.
Clinical Correlation Meetings , Faculty Discussions ( 25 credit Points)
Review of images/films with Faculty Input.
Specific/specialized procedure review/Clinical Case Conference.
Disease/Journal Club, Round Table Discussions.
3.

INTERPRETATION/IMAGING TECHNIQUE SESSION CREDITS. (TOTAL 175 )

Fellow should be able to determine the appropriate diagnostic test for a given clinical
problem, deliver a cogent consultation to clinical colleagues, and accurately determine
the choice of imaging modality and protocol for neuroradiologic studies.
A Candidate is expected to maintain certified Log book indicating number
of cases dealt with individually or under the guidance of faculty for each
Module.

4.
Fellowship Examination 50 Credit Points (Terminal Exam by MCQs)
The examination for a particular course may be conducted according to the requirement

of a course.
Course Director/Programme Director is required to fill up the requirements
according to guidelines presented below and submit it to University
A)Didactic Credits :( 25 Credits )
Didactic on various topics as per syllabus spread over one Hour lecture. Total 10-20
Lectures
(Please specify the subjects in chronological order required for the course and
breakup of the credits allotted according to importance of the subject)
1.
2.
3.
4.
5.

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B)INTERPRETATION/IMAGING TECHNIQUE SESSION CREDITS.


(TOTAL 175 )
(Please specify the subjects and topics/modules in importance order required for
the course and breakup of the credits allotted according to importance of the
subject)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

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C)Other

Fellowship Examination
The examination for a particular course will be conducted at the end of the course. The
examination should be of MCQ type for judging overall proficiency of a Fellow.
Credit Points System: Most Fellows confuse credit based system with a different
evaluation system in medical education. The credit based system is rather a scientifically
accepted system which allows different weightage to different courses in a program

based on its utility in the overall program structure. Over a period of time it has been
identified that every program must have some learning objective defined to it. It is also
accepted fact that only a flexible credit based structure can provide the best training and
learning where the student can learn at his own pace and can learn what he perceives that
would help him in his professional career.
The Advantages of credit based evaluation system are 1) Skilled fellows can always go
for the maximum credits (2) Students can learn at their own pace. Practising Surgeons
busy in practise will find it to be more suitable. Students can come back and finish the
operative modules any time within a stipulated time and in any order. Only the Soft skill
development in skills laboratory setup has to be finished first (3) Students get the
freedom to choose and identify (4) Fellows can translate their innate capabilities to
credits and get the know-how of more than one discipline increasing their horizons
Since the entire course is Credit System based, for each Module, the candidates will be
assigned credits for their work by respective Faculty/Institute. The candidates may finish
their modules and earn credits in Operative sessions within a certain stipulated time
(maximum 3 years and minimum 1 year) in any order depending upon their availability
of time and convenience. The basic credits for any system as stipulated by faculty of a
particular course, however, will have to be finished first. The fellows may be rotated
with different expert faculties / Institutes of a specific module so as to learn maximum
from the respective experts in their actual operative module.